Gabapentin is used primarily for the treatment of seizures, neuropathic pain, and hot flashes.^[1] There are, however, concerns regarding the quality of the research on its use to treat migraines, bipolar disorders, and pain.^[2]

Pain

Gabapentin provides significant pain relief in about a third of people who take it for fibromyalgia or chronic neuropathic pain.^[3] It is also effective in reducing narcotic usage post operatively^[4] and is helpful in neuropathic pain due to cancer.^[5] It has not been shown to be useful for HIV associated sensory neuropathy.^[6] When used for neuropathic pain it does not appear superior to carbamazepine.^[7] Further evidence is needed to determine if it is effective for migraine prevention.^[8] It appears to be equally effective as pregabalin and is of lower cost.^[9] It does not appear to be of benefit in treating complex regional pain syndrome.^[10]

Seizures

Gabapentin is approved for treatment of focal seizures in a number of countries^[11] and evidence supports its use for treating partial and mixed seizure disorders however there is insufficient evidence for its use in generalized epilepsy.^[12] There is little data to support its initial use over older anticonvulsant medication for any type of seizure disorder.^[13]

Other

There is some evidence of benefit in acquired pendular nystagmus and infantile nystagmus but not in periodic alternating nystagmus.^[14][15] Gabapentin may help with menopausal symptoms.^[16][17] It may be effective in reducing pain and spasticity in multiple sclerosis.^[18] Gabapentin is not supported for alcohol withdrawal,^[19] and treatment of smoking cessation have had mixed results.^[20][21]